Acton Fire Department now has ALS paramedics

The Acton Fire Department now offers Advanced Life Support services for calls requiring greater medical intervention.

According to the fire department's ALS Coordnator Pat McIntyre, starting three weeks ago, one of the department's two ambulances is staffed with two paramedics, 24 hours a day, seven days a week.

According to Chief Robert Hart, the idea for upgrading to ALS first started germinating as far back as 2010, with Acton's previous chief. At that time, Emerson Hospital ran an "intercept" service to help take care of patients needing ALS services. Emerson paramedics would respond to a call, typically meeting up with a town ambulance to evaluate the patient, taking over the call if necessary. In 2010, Hart said, Emerson was looking to get out of the intercept business.

From this came CMERA (Central Middlesex Emergency Response Association) which consisted of several towns including Concord, Lincoln, Weston, Acton, Maynard, Littleton, Boxborough, and Carlisle. Pro EMS, a Cambridge-based emergency medical services company, was contracted to Emerson Hospital as Emerson Paramedics, and they were tasked with responding to calls requiring advanced life support services.

Hart stressed Acton was not displeased with Pro EMS or CMERA and the model had worked well for years. But times - and need - changed.

"Our call volume is increasing to the point where it really makes sense for us to do this in house," said Hart.

McIntyre said Pro EMS will remain as an ALS backup to Acton.

In 2016, Hart said, the push for the program began. On the town side, there was money. On the state side, there was learning the regulations, filing the permits and working the bureaucracy. According the McIntyre, there were two paramedics on staff when he came on in 2013. They have now hired nine additional and are looking for two more. Combined, there is more than 100 years of experience in the ambulance crews.

All Acton fire fighters McIntyre said, are also basic emergency medical technicians or EMTs. They can administer basic first aid and life support services and dispense certain lifesaving drugs such as epinephrine.

Paramedics can do much more, including dispensing approximately 40 different kinds of drugs, starting an intravenous line and reading and interpreting an electrocardiogram.

"It's a significantly higher level of care," said McIntyre.

Reasons for ALS

An increase in call volume is one driver in making the switch, according to Hart. In 1993, he said, Acton averaged five calls a day for either medical or fire. In 2017, that number is now just shy of 17 calls per day. Myriad reasons - population growth, improved 911, an older population among them - have fueled the increase in call volume.

Cost and training

"There's a lot that goes into building an ALS service, expense-wise," said. Hart.

This included the increased training, cost of additional drugs and equipment, and increased compensation for paramedics. However, he said, "capturing" an ALS call does bring in more revenue. He believed that the added revenue offsets cost increases and that he believed the program is revenue neutral.

Hart added that the department didn't do this upgrade to make money.

"The real reason," Hart said, "is to provide a faster bedside medic to our citizenry and more definitive care."